Early Predictive Factors of Hypofibrinogenemia in Acute Trauma Patients
Background: Uncontrolled hemorrhage still remains a major cause of trauma-associated mortality. The events resulting in acute traumatic coagulopathy, particularly hypofibrinogenemia, make control of bleeding difficult. It is essential to timely predict, diagnose, and manage trauma-induced coagulopat...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2018-01-01
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| Series: | Journal of Emergencies, Trauma and Shock |
| Subjects: | |
| Online Access: | http://www.onlinejets.org/article.asp?issn=0974-2700;year=2018;volume=11;issue=1;spage=38;epage=41;aulast=Paydar |
| _version_ | 1828239692471992320 |
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| author | Shahram Paydar Behnam Dalfardi Zahra Shayan Leila Shayan Jalal Saem Shahram Bolandparvaz |
| author_facet | Shahram Paydar Behnam Dalfardi Zahra Shayan Leila Shayan Jalal Saem Shahram Bolandparvaz |
| author_sort | Shahram Paydar |
| collection | DOAJ |
| description | Background: Uncontrolled hemorrhage still remains a major cause of trauma-associated mortality. The events resulting in acute traumatic coagulopathy, particularly hypofibrinogenemia, make control of bleeding difficult. It is essential to timely predict, diagnose, and manage trauma-induced coagulopathy. Aims: The aim of this study is to determine clinical and easily available laboratory variables that are predictive of hypofibrinogenemia in acute trauma patients. Settings and Design: This 2-year retrospective work examined the data of major trauma patients that were referred to Shahid Rajaee Hospital's emergency room in hemorrhagic shock condition. Materials and Methods: Fibrinogen level was assessed for these patients on their arrival at our facility. Along with clinical and routine paraclinical variables, we evaluated the predictive value of these variables for a fibrinogen level below 100 mg/ml. Results: A total of 855 cases were included (females: 16.4%; and males: 83.6%) in the study. The mean ± SD age was 36 ± 17.9 years, and the mean ± SD injury severity score was 12.2 ± 9. Motor vehicle accident was the most common cause of injury. Three factors, including arterial pH (cut off point = 7.34; area under the curve [AUC]: 0.59), base excess (cutoff point = −4.3; AUC: 0.60), and patients' gender had a significant association with the fibrinogen level under 100 mg/ml. When three factors of pH, BE, and patients' gender are being assessed simultaneously, the AUC became 0.62 (the predictive ability improved). Conclusions: Variables, including arterial pH, BE level, and patients' gender have predictive value for fibrinogen transfusion in trauma. |
| first_indexed | 2024-04-12T21:27:01Z |
| format | Article |
| id | doaj.art-ac044ce0797f43d7ba3cc07fbfa1cb15 |
| institution | Directory Open Access Journal |
| issn | 0974-2700 |
| language | English |
| last_indexed | 2024-04-12T21:27:01Z |
| publishDate | 2018-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Emergencies, Trauma and Shock |
| spelling | doaj.art-ac044ce0797f43d7ba3cc07fbfa1cb152022-12-22T03:16:09ZengWolters Kluwer Medknow PublicationsJournal of Emergencies, Trauma and Shock0974-27002018-01-01111384110.4103/JETS.JETS_37_17Early Predictive Factors of Hypofibrinogenemia in Acute Trauma PatientsShahram PaydarBehnam DalfardiZahra ShayanLeila ShayanJalal SaemShahram BolandparvazBackground: Uncontrolled hemorrhage still remains a major cause of trauma-associated mortality. The events resulting in acute traumatic coagulopathy, particularly hypofibrinogenemia, make control of bleeding difficult. It is essential to timely predict, diagnose, and manage trauma-induced coagulopathy. Aims: The aim of this study is to determine clinical and easily available laboratory variables that are predictive of hypofibrinogenemia in acute trauma patients. Settings and Design: This 2-year retrospective work examined the data of major trauma patients that were referred to Shahid Rajaee Hospital's emergency room in hemorrhagic shock condition. Materials and Methods: Fibrinogen level was assessed for these patients on their arrival at our facility. Along with clinical and routine paraclinical variables, we evaluated the predictive value of these variables for a fibrinogen level below 100 mg/ml. Results: A total of 855 cases were included (females: 16.4%; and males: 83.6%) in the study. The mean ± SD age was 36 ± 17.9 years, and the mean ± SD injury severity score was 12.2 ± 9. Motor vehicle accident was the most common cause of injury. Three factors, including arterial pH (cut off point = 7.34; area under the curve [AUC]: 0.59), base excess (cutoff point = −4.3; AUC: 0.60), and patients' gender had a significant association with the fibrinogen level under 100 mg/ml. When three factors of pH, BE, and patients' gender are being assessed simultaneously, the AUC became 0.62 (the predictive ability improved). Conclusions: Variables, including arterial pH, BE level, and patients' gender have predictive value for fibrinogen transfusion in trauma.http://www.onlinejets.org/article.asp?issn=0974-2700;year=2018;volume=11;issue=1;spage=38;epage=41;aulast=PaydarBlood component transfusionfibrinogenhemorrhageshock |
| spellingShingle | Shahram Paydar Behnam Dalfardi Zahra Shayan Leila Shayan Jalal Saem Shahram Bolandparvaz Early Predictive Factors of Hypofibrinogenemia in Acute Trauma Patients Journal of Emergencies, Trauma and Shock Blood component transfusion fibrinogen hemorrhage shock |
| title | Early Predictive Factors of Hypofibrinogenemia in Acute Trauma Patients |
| title_full | Early Predictive Factors of Hypofibrinogenemia in Acute Trauma Patients |
| title_fullStr | Early Predictive Factors of Hypofibrinogenemia in Acute Trauma Patients |
| title_full_unstemmed | Early Predictive Factors of Hypofibrinogenemia in Acute Trauma Patients |
| title_short | Early Predictive Factors of Hypofibrinogenemia in Acute Trauma Patients |
| title_sort | early predictive factors of hypofibrinogenemia in acute trauma patients |
| topic | Blood component transfusion fibrinogen hemorrhage shock |
| url | http://www.onlinejets.org/article.asp?issn=0974-2700;year=2018;volume=11;issue=1;spage=38;epage=41;aulast=Paydar |
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